Family planning and Afghan refugee women and men living in Melbourne, Australia: new opportunities and transcultural tensions

Abstract

This research aimed to explore the family planning perspectives and experiences of Afghan women and men living in Melbourne. A total of 57 Afghan women and men participated in six focus groups and 20 semi-structured interviews. The majority of participants indicated a preference for two or three children and were open to using modern contraception. However, many women described experiencing negative side effects when using hormone-based contraception and expressed difficulty negotiating condom use with their husbands as an alternative. Some women described how these difficulties resulted in inconsistent contraceptive practices and, at times, unintended pregnancy. Participants recognised that health professionals have an important role in addressing their family planning needs. This study highlights the ways in which Afghan women and men are changing in relation to their family planning beliefs and practices, and the opportunities, challenges and transcultural tensions they experience as they navigate these issues in Australia. ARTICLE HISTORY

Men of refugee and migrant backgrounds resettled in Australia: A scoping review of sexual and reproductive health research

“…Whilst some studies described refugee and migrant men as having 'reasonable' (Gray et ). Language and literacy pro ciencies also made accessing online family planning information di cult for some refugee and migrant background men (Russo et al, 2020). SRH knowledge, however, signi cantly improved the longer refugee and migrant men had lived in Australia (Dean et al, 2017b).…”

“…Across the reviewed studies, three explored attitudes in relation to fertility management (Bot eld et al, 2020; Russo et al, 2020; Weston et al, 2002). Overall, refugee and migrant men were open to having fewer children following migration, associated with the belief that they experienced a reduction in authority within the family (Russo et al, 2020). Men at large were also open to using contraception, associating it with being 'open-minded' and 'modern' and resisting the idea that it was religiously forbidden, or something men could 'force' upon women.…”

“…Men at large were also open to using contraception, associating it with being 'open-minded' and 'modern' and resisting the idea that it was religiously forbidden, or something men could 'force' upon women. However, men's preference not to use condoms, often relied on withdrawal to avoid pregnancies: 'At the start, I was going with condoms, and after that, I thought 'nah', I went just with the withdrawal method, and that's it … I didn't like condoms, so I'm going with the withdrawal method and it's working' (Russo et al, 2020).…”

“…While the ethnicity and gender of the provider were 'not important' (Ramanathan et al, 2013) and 'not a necessity' (Russo et al, 2020) in some studies, Iranian refugee and migrant men reported that 'Iranian same-gender sexologists and gynecologists' and 'Iranian health professionals can act as enablers for Iranian migrants in providing SRHS' (Ilami & Winter, 2020). Gender of the provider was also identi ed to be an important factor in accessing SRH care.…”

“…Taboo: SRH is 'no man's land' SRH taboo, shaped by cultural and generational differences, emerged as an important factor shaping the way refugee and migrant men perceive and access SRH (Agu et ) by refugee and migrant men, making 'discussion of sexual health and HIV related issues appeared to be more acceptable' (Agu et al, 2016). Back home, however, refugee and migrant men 'do not have courage to talk about sexual health -even with a doctor' (Russo et al, 2020). This culture of shame and stigma regarding the discussion of SRH issues is identi ed to be a major barrier in discussing the topic freely with health care providers (Russo et al, 2020)…”